Dr. Gorantla on the Impact of the APHINITY Trial in HER2+ Breast Cancer

Vikram C. Gorantla, MD, clinical assistant professor, UPMC Hillman Cancer Center, discusses the impact of the APHINITY trial on the treatment of patients with HER2-positive breast cancer.

Trastuzumab (Herceptin) was a game-changer for patients with HER2-positive breast cancer, says Gorantla, and the field has seen much success since the introduction of the agent. As pertuzumab (Perjeta) is approved in the neoadjuvant setting, it seemed logical to see if it would be effective in the adjuvant setting. Adding pertuzumab to trastuzumab in the adjuvant setting was done in an effort to improve outcomes even further, Gorantla explains.

The APHINITY trial showed that adjuvant treatment with pertuzumab, trastuzumab, and chemotherapy elicited a 3-year invasive disease-free survival rate of 94.1% versus 93.2% for patients with HER2-positive early breast cancer who received trastuzumab plus chemotherapy and placebo. These findings led to the December 2017 FDA approval of the regimen for this population. Gorantla says that benefit was seen largely in node-positive patients, as well as estrogen receptor—negative and progesterone receptor–negative patients. This is where the regimen will most likely be used, he concludes.